Failure to Implement Enhanced Barrier Precautions for Resident with Open Surgical Wound
Penalty
Summary
A deficiency was identified when a resident with an open surgical wound on the right ear, resulting from the removal of squamous cell carcinoma, was not placed on enhanced barrier precautions (EBP) as required by facility policy. Observations revealed the resident had a bandaged ear with visible blood, and the electronic medical record documented a slow-healing surgical wound with drainage and red, lump-like tissue. Despite these findings, there was no documentation of EBP implementation in the resident's record. Further observations showed there were no signs indicating EBP inside or outside the resident's room, nor was personal protective equipment (PPE) such as gowns and gloves available for staff use during contact care. During wound care, a registered nurse used gloves but did not utilize a gown, and confirmed that EBP had not been initiated since the surgical procedure. The interim director of nursing/infection preventionist acknowledged that EBP should have been in place for the resident due to the open wound, in accordance with the facility's policy.